Q: What should you do for a new injury (strain or sprain?)
A: Of course you should immediately see the Athletic Trainer. However if you are away from school, here are some easy steps to remember. The best way to remember it is to think PRICE
P - Protection - Splint if need be. Crutches can help to take pressure of a new injury.
R - Rest - Give the injury the proper rest to heal correctly
I - Ice - Ice should be used for the first 24 to 72 hours to help reduce inflammation/swelling and help with pain. Ice should be applied for 20 minutes and taken off for twenty minutes. One should never use heat for the first 72 hours.
C - Compression - An ace bandage or any compression dressing is very effective in reducing and preventing any swelling from occurring. Reducing the amount of swelling will help speed up the healing process.
E - Elevation - By keeping the injured body part above the level of the heart, you use gravity to your advantage help prevent/decrease swelling.
Q: Is time and rest enough for an injury to heal properly?
A: No. It is important that a comprehensive rehabilitation plan be developed that will ensure the athlete is at the same if not better level then before injury. It is also important to consider the cause of the injury to prevent a reoccurrence. An example would include a typical lateral ankle sprain. In an ankle sprain, ligaments are torn. However, the muscles of the ankle can become weak, even though they were not injured at the time of the injury. If an athlete provides only rest for this injury, the athlete will return with a weaker ankle and could predispose themselves to another. Undergoing a lower leg strengthening program as well as exercises to maintain their balance skills would ensure a safe return to sport. Another example would include non-stress fracture type "shin splint" injuries. This type of injury is usually a result of overuse and over-training. Typically, the athlete is training at a level that is too much for the body to tolerate and a syndrome of irritation and inflammation occurs. Rest is an important part of the process, but the athlete must strengthen the lower leg muscles so it can handle the stress of the sport. A logical gradual return to sport is also warranted. Several modalities can also be utilized to help accelerate the healing process. I highly recommend an appropriate rehabilitation program for all injuries.
Q: What is better, Heat or Cold?
A: It is very important to understand that if an injury is new or an old injury is aggravated, ONLY use Cold. When an injury occurs, there is damage to one's tissues. The result is swelling to the injury site. Although the body’s response is meant to help heal the injury, in most cases there is too much swelling which actually slows down the recovery process. Ice is a very effective tool to help control the swelling. If one applies heat to the area, then the amount of swelling will be increased which could produce disastrous effects. An example would be applying heat to a thigh contusion/bruise. The increase in swelling could develop into a condition called myositis ossificans, in which the body actually develops a bony mass in the muscle. This condition will result in a significant time loss for the athlete. Ice also helps break the PAIN SPASM cycle. When the body is injured, the muscles go into a protective spasm. This spasm will result in pain. The pain in turn will increase the body’s spasm response. Ice is very effective in reducing the pain of the injury and also the muscle spasm. This in turn will accelerate the recovery of the injury. Ice is also very effective after practices/games when an athlete returns to sport but is still not completely recovered from an injury.
Heat is very effective part of recovery a couple of days after a new or aggravated injury. Heat is also helpful as a warm up tool for tight muscles before activity. Heat helps bring nutrition to an injury and helps improve tissue extensibility. As part of a rehab program, it is common to heat the body part before rehab/exercises and ice down after, as long as the acute phase is over. If you are not sure, always remember that you can't go wrong with ice and always check with the Certified Athletic Trainer.
Q: How effective are those topical heat / cold creams in healing an injury?
A: Actually they don't do anything and could potentially make an injury worse. It is important to understand that these creams contain chemical irritants that irritate the nerves in your skin, and in turn produce either a warm or cold "sensation". The cream actually never gets to the muscles and there is no real heating or cooling effect. This could be dangerous with a new injury. If one uses this cream with a hamstring strain in hopes to loosen the muscle, all that will happen is a masking of the pain. An athlete could easily increase the severity of injury if they were to compete. These creams are best left for mild soreness relief due to workouts, not injuries.